Abstract
orientation of the renal pelvises and the location of the calculus often prevents percutaneous access. However, we show that by keeping a few key principles in mind, laparoscopic surgical success can be achieved in such situations. METHODS: We performed a left laparoscopic pyelolithotomy in a 33 year old woman with a 5cm staghorn calculus. The patient had no evidence of ureteral pelvic junction (UPJ) obstruction on mag-3 renal scan. A retrograde was performed and a 7 fr. double J stent was placed prior to the procedure. Port placement was performed with 4 ports placed in a diamond shape below the umbilicus. The ureter and renal pelvis
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